Food & Drink

Ileostomy Food & Drink - Dietary Suggestions

If you have coped for a long period of time with ulcerative colitis or Crohn’s disease you will almost certainly have given a great deal of thought to all items of food and drink and their possible relationship to any flare-up of the disease. What a relief to now be assured that an ileostomate has no limitations on diet, in fact “diet” is a very inappropriate word. You can now eat normally, along with the rest of your household, enjoying your meals and experiencing the pleasure of a healthy appetite once more. Whatever you eat, at whatever time of the day, your stoma will pass faeces into your appliance throughout the 24 hours. Of course the rate is not constant and there will be quite prolonged periods when nothing is passed and then a much more active time. You will also ind that the consistency of the discharge commonly varies throughout each day, being usually like that of toothpaste, but may be quite liquid after breakfast and almost “formed” after a roast dinner.

When the ileostomy is very new the discharge tends to be very fluid at all times and in order to reduce the amount of output it is helpful to avoid too much roughage as this stimulates the small intestine to greater activity, and not only does this roughage come through but with it an extra amount of water. Therefore, in the first few weeks and at any time that the excreta is more watery than usual, one should avoid such things as cabbage, lettuce, nuts and orange pith and keep to milky and starchy foods. At all other times these items should be included as part of your healthy, well balanced meals.

One of the main functions of the large intestine is to absorb water and salt from the waste matter stored there. Although the small intestine gradually adapts by increasing its own absorption of water, your body will probably need more fluids than it did before surgery. To avoid becoming dehydrated, you need to drink plenty of water, juice or other liquids each day and you should pass a minimum of 1 litre of urine each day.

A major increase in the ileostomy output (due to a number of factors including an attack of gastroenteritis or a mild obstruction) must be treated seriously and anyone who passes an extra litre or two of excreta through the ileostomy would be well advised to consult their doctor. Shortage of salt leads to general weakness, a tendency to faint and abdominal cramps. Salt intake should be increased as soon as extra output is noticed. Extra salt can be taken as a solution of half a teaspoon in 500ml water (if more is added it is nauseating). If you get diarrhoea, there are some foods you can eat that will help to thicken the stool. These include apple sauce, mashed potato, ripe bananas, marshmallows, noodles, yoghurt and cheese.

Such episodes will be few and far between and, as stated earlier, normal meals can be eaten with the family. Enjoy your favourites - sweet corn, asparagus, figs, raspberries - the only difference in the faeces will be in consistency, colour and, sometimes, odours. There is a considerable variation between different people, most having no ileostomy odour concerns at all, while it can be a perceived problem to a few. Mostly the odour is of the food consumed - e.g. fish, asparagus, green peppers and onions - which still retain their own smell when passed! Normal faeces acquire their typical odour during their transit time in the large bowel, which has now been removed and thus this type of odour is not encountered. Of course, modern appliances are completely odour proof and you will only be aware of any odours at all when emptying the pouch into the toilet pan.

The number of occasions on which the appliance needs emptying will vary from person to person. Following a meal, the transit time for the food to be digested and the faeces to be passed into the bag is usually only a few hours. The time of your main meal of the day is entirely your choice and there is no need to stick to a regular pattern. The main thing is to retain your normal family meal time and never become a slave to your ileostomy. If you do eat your main meal in the evening you will almost certainly have to get up in the night to empty your bag, but this is of little consequence. You will soon drop off to sleep again after a quick trip to the bath room.